Idiopathic Non-traumatic Facial Nerve Palsy (Bell's Palsy) in Neonates; An Atypical Age and Management Dilemma (original) (raw)
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A rare case of acquired infantile Bell’s palsy
International Journal of Contemporary Pediatrics, 2021
Bell’s palsy, an acute onset, acquired, isolated peripheral facial palsy, usually follows a viral illness, is common disorder post infancy to adolescence. It has a favourable prognosis with spontaneous resolution, or with use of oral corticosteroids. Its presentation in early infancy is very unusual, as in our case report of 3 month old infant with an ovoid mass lesion in parotid, which disappeared after therapy with corticosteroids with no residual deficit.
Seminars in Pediatric Neurology, 2003
Bell's palsy is a self-limiting idiopathic rapid onset facial palsy that is non-life-threatening and has a generally favorable prognosis. Facial paralysis can be caused by numerous conditions, all of which should be excluded before a diagnosis of Bell's palsy is reached. The etiopathogenesis of Bell's palsy is uncertain; acute immune demyelination triggered by a viral infection may be responsible. Controversy exists regarding treatment options. This article reviews the differential diagnosis and diagnostic and therapeutic options and discusses the controversies related to the various treatment modalities (steroids, acyclovir, and surgery). A simple practical approach to diagnosing and treating children with Bell's palsy is suggested.
Facial nerve palsy in children: A case series and literature review
Otolaryngology Case Reports, 2021
The facial nerve is the most common cranial nerve to have a disorder. In adults, the incidence has been reported to be as high as 40 cases per 100,000 patients annually. In the pediatric population, the frequency of facial nerve palsy is much less. It is estimated that children over the age of 10 have an incidence of 10 per 100,000 annually and those under the age of 10 to be less than 3 per 100,000 annually. Nonetheless, when children are affected, it has a tremendous impact on the child and can cause great distress to the family. As with adults, the most common etiology of facial palsy in children is idiopathic (Bell's Palsy). However, the most frequent identifiable causes of facial palsy in children are different from that in adults. In children, when not idiopathic, infection followed by trauma and congenital conditions are the most commonly etiologies of facial nerve palsy. The diagnosis, evaluation, treatment and outcomes of facial palsy in children will be reviewed. In addition, a series of representative cases of pediatric facial palsy at our children's hospital will be presented.
Management of Bell"s palsy: a report of 2 cases
Journal (Canadian Dental Association), 2008
Bell"s palsy is a neuropathy of the peripheral seventh cranial nerve, resulting from traumatic, compressive, infective, inflammatory or metabolic abnormalities or it can be idiopathic. HIV, Epstein-Barr virus and hepatitis B virus have been suspected as initiating organisms, but herpes simplex virus is the most frequently implicated. This report describes 2 cases of Bell"s palsy in children that were managed with antiviral agents. Both patients experienced complete recovery within 28 days; after 1 year follow-up, no recurrence was observed and both patients have normal facial movement. Differential diagnosis is essential to guide the treatment plan in Bell"s palsy. Special attention should be given to children with respect to prescription of medications that can cause important side effects.
Facial nerve palsy in childhood
Brain and Development, 2011
Facial nerve palsy in children is usually idiopathic but can also result from many conditions such as neoplasias, systemic diseases, or congenital anomalies with poor prognosis. Children with idiopathic facial palsy (Bell's palsy) have a very good prognosis, while treatment with prednisone does not certainly improve the outcome. The causes of facial nerve palsy in childhood differ from those in adults. A detailed investigation and differential diagnosis are recommended for facial palsy in children.
Bell's palsy: a summary of current evidence and referral algorithm
Family Practice, 2014
Spontaneous idiopathic facial nerve (Bell's) palsy leaves residual hemifacial weakness in 29% which is severe and disfiguring in over half of these cases. Acute medical management remains the best way to improve outcomes. Reconstructive surgery can improve long term disfigurement. However, acute and surgical options are time-dependent. As family practitioners see, on average, one case every 2 years, a summary of this condition based on common clinical questions may improve acute management and guide referral for those who need specialist input. We formulated a series of clinical questions likely to be of use to family practitioners on encountering this condition and sought evidence from the literature to answer them. The lifetime risk is 1 in 60, and is more common in pregnancy and diabetes mellitus. Patients often present with facial pain or paraesthesia, altered taste and intolerance to loud noise in addition to facial droop. It is probably caused by ischaemic compression of the facial nerve within the meatal segment of the facial canal probably as a result of viral inflammation. When given early, high dose corticosteroids can improve outcomes. Neither antiviral therapy nor other adjuvant therapies are supported by evidence. As the facial muscles remain viable re-innervation targets for up to 2 years, late referrals require more complex reconstructions. Early recognition, steroid therapy and early referral for facial reanimation (when the diagnosis is secure) are important features of good management when encountering these complex cases.
Bell Palsy: Facts and Current Research Perspectives
Bentham Science 23(2):203-214., 2024
Bell palsy is a non-progressive neurological condition characterized by the acute onset of ipsilateral seventh cranial nerve paralysis. People who suffer from this type of facial paralysis develop a droop on one side of their face, or sometimes both. This condition is distinguished by a sudden onset of facial paralysis accompanied by clinical features such as mild fever, postauricular pain, dysgeusia, hyperacusis, facial changes, and drooling or dry eyes. Epidemiological evidence suggests that 15 to 23 people per 100,000 are affected each year, with a recurrence rate of 12%. It could be caused by ischaemic compression of the seventh cranial nerve, which could be caused by viral inflammation. Pregnant women, people with diabetes, and people with respiratory infections are more likely to have facial paralysis than the general population. Immune, viral, and ischemic pathways are all thought to play a role in the development of Bell paralysis, but the exact cause is unknown. However, there is evidence that Bell's hereditary proclivity to cause paralysis is a public health issue that has a greater impact on patients and their families. Delay or untreated Bell paralysis may contribute to an increased risk of facial impairment, as well as a negative impact on the patient's quality of life. For management, antiviral agents such as acyclovir and valacyclovir, and steroid treatment are recommended. Thus, early diagnosis accompanied by treatment of the uncertain etiology of the disorder is crucial. This paper reviews mechanistic approaches, and emerging medical perspectives on recent developments that encounter Bell palsy disorder.
Pediatric facial nerve paralysis: Patients, management and outcomes
International Journal of Pediatric Otorhinolaryngology, 2005
Objective: To characterize the causes and treatment of facial nerve paresis (FNP) in pediatric patients. Method: Retrospective study in a tertiary care pediatric hospital. Thirty-four patients identified with partial or complete FNP evaluated between 1997 and 2003. A review of the medical records including sex, age, laterality, etiology, therapy, severity of paralysis according to House-Brackman (HB) six-point grading scale, duration, and degree of recovery. Results: Thirty-five cases of FNP. Causes of FNP were infectious (13), traumatic , iatrogenic (5), congenital (4), Bell's/Idiopathic (3), relapsing (2) and neoplastic (1).
Childhood peripheral facial palsy
Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery, 2018
The objectives of this study were to evaluate the demographic and clinical characteristics, causes, treatment patterns, outcome, and recurrence of childhood peripheral facial palsy. We performed a retrospective study of 144 peripheral facial palsy patients, under 18 years old in a tertiary care pediatric hospital. Medical charts were reviewed to analyze the age, gender, side of facial nerve paralysis, family history, cause, grading by the House-Brackmann Facial Nerve Grading Scale (HBS), results of diagnostic tests, therapies, outcomes, and recurrence. Causes were as follows: 115 idiopathic (Bell's palsy) facial palsy (79.9%), 17 infections (11.8%) (9 otitis media, 4 varicella zoster virus (VZV) infection, 3 tooth abscess, and 1 group A β-hemolytic streptococcus infection), 7 trauma (4.9%), 4 congenital-syndrome (2.8%), and 1 (0.7%) arterial hypertension. There was no difference in age, sex, family history, grading, or outcome between idiopathic and cause-defined facial palsy. A...
Bell’s palsy: Our experience and review of 30 cases
Otorhinolaryngology-Head and Neck Surgery, 2019
Bell's palsy [BP], named after Sir Charles Bells, is defined as acute onset peripheral facial nerve paralysis that is idiopathic, comprising of about 70% of the usual facial palsy cases. Many controversies exist about the exact diagnostic protocol and treatment options for Bell's palsy, but most commonly followed treatment options are corticosteroids with or without acyclovir, acupuncture, physiotherapy. In our study we are presenting clinicopathological 30 cases of BP with details regarding age of presentation, site of palsy, onset, and grade of paresis, treatment and sequelae. The purpose is to look over clinical characteristics of Bell's palsy to help provide information regarding the disease in our hospital setting and correlation with other similar studies in literature.